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A Campaign to Carry Pregnancies to Term

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The March of Dimes opened a new campaign this summer to curb the large and growing number of otherwise healthy pregnancies that are deliberately ended early by induced labor or Caesarean delivery.

Research has clearly shown that a change in approach that emphasizes allowing babies to develop fully when both mother and baby are doing well could result in healthier babies and lower medical costs. The campaign is called “Healthy babies are worth the wait.”

What prompted the campaign is what many experts view as an alarming trend in American obstetrics — the steady rise in elective deliveries of singleton babies before 39 weeks of gestation, when fetal development is complete. Gestation is calculated from the first day of a woman’s last menstrual period. Studies have shown that as many as 36 percent of elective deliveries now occur before 39 weeks, and many of these early deliveries are contributing to an unacceptable number of premature births and avoidable, costly complications.

Although guidelines issued 12 years ago by the American College of Obstetricians and Gynecologists cautioned against elective delivery by induction or Caesarean before 39 weeks, an overwhelming majority of new mothers and many doctors who deliver babies believe it is just as safe for birth to occur weeks earlier.

Complications

But the medical facts say otherwise. With each decreasing week of gestation below 39 to 40 weeks, there is an increased risk of complications like respiratory distress, jaundice, infection, low blood sugar, extra days in the hospital (including time in the neonatal intensive care unit), and even deaths of newborn babies and older infants.

Although tests may show that the baby’s lungs are well developed at, say, 37 weeks, research has demonstrated that the risk of newborn complications is still significantly higher than if delivery occurs two to three weeks later. In a study published last December of babies demonstrated to have mature lungs before birth, those delivered at 36 to 38 weeks had two and a half times the number of complications compared with those delivered at 39 to 40 weeks. Problems more common among babies delivered earlier in gestation included respiratory distress, jaundice and low blood sugar.

Yet in 2008 among a national sample of 650 women who had recently given birth, 51.7 percent chose 34 to 36 weeks of gestation as “the earliest point in pregnancy that it is safe to deliver the baby” and 40.7 percent chose 37 to 38 weeks. Only 7.6 percent selected 39 to 40 weeks, the true length of a full-term pregnancy, and the time when complications, including stillbirth, are least likely to occur.

Although many women think that weight gain is all that happens to babies during the last few weeks of pregnancy, Dr. Eve Lackritz, chief of the maternal and infant health branch of the national Centers for Disease Control and Prevention in Atlanta, said vital organs like the brain, lungs and liver are still developing. There are also fewer vision and hearing problems among babies born at full term.

“Babies aren’t fully developed until at least 39 weeks,” Dr. Lackritz told a news briefing in New York convened by the March of Dimes. For example, a baby’s brain at 35 weeks gestation weighs only two-thirds of what it will weigh at 39 to 40 weeks.

“If there are no medical complications, the healthiest outcome for both mother and infant is delivery at 40 weeks,” Dr. Lackritz said.

This is not to suggest that women should panic if labor begins earlier on its own. “It’s a whole different story when a woman goes into labor early than when labor is induced,” Dr. Uma M. Reddy of the National Institute of Child Health and Human Development said in an interview. She explained that the labor process helps to prevent lung problems. At the same gestational age, there are fewer respiratory problems when labor occurs naturally than when it is medically induced, Dr. Reddy said.

Dr. Reddy and colleagues analyzed more than 46 million singleton live births that occurred from 1995 to 2006 and found that newborn death rates at 37 weeks of gestation were two and a half to nearly three times the number at 40 weeks and were also elevated at 38 weeks of gestation. For example, in 2006 the infant mortality rate at 37 weeks gestation was 3.9 per 1,000 live births; at 38 weeks, 2.5 per 1,000 births; and at 40 weeks, 1.9 per 1,000 births. They reported their findings in the journal Obstetrics & Gynecology in June. The researchers also found that these so-called early-term births were associated with higher rates of death after birth and during infancy than were full-term births occurring at 39 to 41 weeks.

Dr. Reddy said that the textbook definition of “term pregnancy” as one that lasts from 37 to 41 weeks “is arbitrary — it has no biological basis. If a woman’s water hasn’t broken, if labor hasn’t begun on its own, if there are no medical or obstetrical problems, there’s no reason for a woman to be delivered before 39 weeks.”

The recommendation applies not just to women whose labor is induced, but also to those having a scheduled Caesarean delivery. Too often, women are mistaken about when they got pregnant, which can throw off the calculation of their due date. Even when a “dating”ultrasound is done during the first trimester of pregnancy, there can be as much as a two-week margin of error. Thus, a woman may think her pregnancy has lasted 39 weeks when it is only 37 weeks along. Or she may think she is 37 weeks pregnant when she is only 35 weeks; a delivery at that point would result in a premature birth.

Countering Early Elective Births

Dr. Reddy pointed out that “late preterm births” — between 34 and 37 weeks of gestation — in pregnancies with no complications are more common among older white women with higher levels of education who “are more likely to ask their obstetricians to deliver them before term.”

Well-educated women may be more inclined to want to schedule birth at a convenient time for themselves and other family members. Doctors, too, may suggest an elective delivery so that birth occurs at a time that best suits their schedules, including office hours and vacation times. Sometimes doctors, fearing a malpractice suit if something should go wrong if a pregnancy proceeds to term, choose to deliver babies early when they are alive and well.

To counter the avoidable complications and higher costs associated with preterm elective deliveries, beginning in January 2001 a network of nine urban hospitals in the Intermountain Healthcare system in Utah instituted a program to greatly limit elective deliveries before 39 weeks of gestation. The program included educational programs for doctors, nurses and pregnant women. However, not until strict monitoring of births was instituted by the hospitals did the rate of early deliveries drop to less than 3 percent from 28 percent, with a host of benefits but “no adverse effects” seen on the health of the mothers or babies.

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How Women Can Avoid Unnecessary Cesarean Sections (C-Sections)

-How to Help Yourself or Your Friends/Family to Avoid an Unnecessary C-section

The United States cesarean section rate, which skyrocketed during the 1980s, has plateaued and begun a very slow reversal of this earlier dangerous trend. It appears that increased use of vaginal birth after cesarean section (VBAC) has been a major factor in bringing the increase in c-section rates to an end. This is the main conclusion of a report by Public Citizen’s Health Research Group on the use of cesarean section in U.S. hospitals, findings of which are summarized here. According to the National Center for Health Statistics (NCHS), the c-section rate nationwide increased more than four-fold in a little less than 20 years, rising from 5.5 percent in 1970 to 24.7 percent in 1988. Since then the rate has varied only slightly, actually decreasing modestly after 1990. Meanwhile, between 1985 and 1992, the VBAC rate (the proportion of women with a previous c-section who deliver vaginally) has steadily risen from 6.6 to 25.4 percent. Our own data, collected mainly from state vital records offices, show a nationwide cesarean rate of 22.6 percent for 1992, slightly lower than the 1990 rate of 22.7 percent presented in our previous c-section report. Because of the large number of births used to calculate these cesarean rates, even this small decline was statistically significant. The challenge now is to encourage a much sharper reversal of the earlier trend and work toward a less extensive, more rational use of cesarean surgery.

The upward cesarean surgery trend has been of concern to the Health Research Group for several years. In 1988, we published our first report on this issue, for the first time making data on hospital and physician cesarean rates widely available. Since then, we have continued to expand the size of our state and hospital databases. The current report includes statewide c-section rates from all 50 states and the District of Columbia, statewide VBAC rates from 49 states (only Connecticut is missing) and the District of Columbia, and hospital-specific cesarean rates and VBAC rates from 3,159 hospitals in 41 states. These statistics are calculated from data on the method of delivery used in almost 4 million births occurring in U.S. hospitals in 1992, making our report the most comprehensive source of information on hospital and state cesarean section and VBAC rates available.

Delivery by Cesarean Section

Over most of the past 25 years, the average American woman expecting a child has been increasingly unlikely to deliver her baby vaginally. Nearly one in four pregnant women now have a cesarean section. This operation is similar in scope to an appendix or gall bladder removal in that it involves entering the abdominal cavity and surgically modifying an organ.

For years controversy raged in the United States over whether increased c-section use represented a gross and excessive danger to mothers, a new and more convenient way of delivering normal babies, the guarantee of a perfect baby, the root of the decline in infant deaths, or a knee-jerk response by physicians to problems of malpractice, or a source of added income for doctors and hospitals. At one point, an academic article went so far as to suggest that all women be offered a cesarean at their due date. The answers to most of these questions have become increasingly clear as research accumulates. C-section, while at times a life-saving intervention for both mother and child, can do significant harm to mothers without providing additional benefits to infants when performed outside of certain well-defined medical situations. We are beginning the long road back from an epidemic of unnecessary surgery.

Curing the Cesarean Epidemic

There are many strategies that hospitals, insurers and consumers can pursue in lowering cesarean section rates. Hospitals can address the problem by putting one or more of the following measures in place:

Develop and enforce clinical standards for obstetric care;

Require second opinions for all but emergency cesareans;

Audit and peer-review cesarean operations;

Develop mandatory, hospital-wide information forms which explain to women with previous cesarean sections why VBAC is recommended as the safest course for most women;

Use trained labor companions;

Incorporate midwives and their philosophy of care into labor and delivery care programs; and

Develop a perinatal database to track patient care and clinical outcomes.

Unnecessary C-section is big money for doctorsFinancial incentives driving our current insurance system favor cesarean surgery over vaginal delivery. There are six actions we feel insurance companies should take to correct this situation:

  1. Equalize physician fees for c-section and vaginal delivery;
  2. Pay hospitals through a refined “diagnostic related group” (DRG) compensation system that more closely reflects true cost differences among various types of deliveries;
  3. Use such cost control tools as preadmission certification of elective repeat cesareans and retrospective review;
  4. Select physicians and hospitals with low cesarean section rates as preferred providers;
  5. Provide financial incentives for women to attempt VBAC; and
  6. Use insurance coverage to promote less costly and less technology-driven forms of care.

The most important people to stop this epidemic are those who must undergo and live with the effects of unnecessary cesarean surgery — women. We suggest three steps women can take to lower the risk of unnecessary cesarean surgery:

Determine the cesarean section “track record” of available doctors and hospitals;

Discuss concerns about cesarean section and other forms of medical intervention during labor and delivery with their doctor;

Consider choosing a midwife for prenatal care and as the birth attendant.

In these ways, hospitals, insurers, and consumers can all take action to lower the incidence of expensive and dangerous unnecessary cesarean sections being performed today. This is truly an issue where the interests of good health and cost-containment coincide, creating common ground between health-care consumers and the insurers and employers who pay for this care. With regard to cesarean section, physicians have adopted a style of practice that is in the best interest of neither society nor the individual woman. By taking actions described above, those with a stake in this issue can be instrumental in reversing the 20-year trend that has caused “the c-section epidemic.”

This article is courtesy of Public Citizen Publications

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Why Being A Female Equals BIG BUCKS For The Medical Society

Female Patients Translate into Huge Possibilities for Medical Doctors

Women stand the greatest risk of receiving an unnecessary medical procedure. If you are a female living in the US, when it comes to healthcare, you might as well have a target on your back.

The Centers for Disease Control and Prevention (CDC) reports that one-third of American women have had a hysterectomy by age 60; and half of them have had one by age 65. Yet 85 percent of these surgeries are unnecessary, according to Ernst Bartsich, a clinical associate professor at Weill Cornell Medical College.

This adds up to more than $17 billion a year on direct doctor and hospital charges for hysterectomies.

If you’ve had a complete hysterectomy, meaning you’ve also had your ovaries and cervix removed, you don’t need a Pap test, which examines cells scraped from your cervix. Yet, a study in 2004 showed that 10 million women a year who don’t have a cervix are still getting Pap tests consisting of a scraping of cells from their vaginal walls – when no professional organization recommends this screening for women without a cervix!

For younger women who are in their child-bearing years, the health profession has found a different way to make money off you, to the tune of an extra $3 billion a year.

Spontaneous deliveries – waiting for a baby to come on its own – can be time-consuming for modern doctors, and can test your patience if you’re the mom-to-be. That’s why today 32 percent of American births today are through Caesarean sections (C-sections).

According to Intermountain Healthcare, C-sections are costly in more ways than one:

  • They are the most common surgical procedure performed in America, increasing more than 50 percent since the 1990s.
  • They cost an average of $16,671, compared to $9,428 for a vaginal delivery.
  • Many are being done after a pre-term, elective induction that hasn’t proceeded quickly enough.

Additionally, a New England Journal of Medicine study showed women have up to four times the risk of complications with a C-section than a vaginal birth, ranging between $2,000 and $200,000 in additional costs.

And the complications can be serious, according to a report in the Wall Street Journal, putting the babies at increased risk of brain, liver, and lung development problems. Caesarean-delivered babies are also more likely to need CPR, and to have significantly higher rates of respiratory distress, sepsis and hypoglycemia.

So why are C-sections so prevalent?

It’s largely a desire for control on the part of families, physicians and hospitals, the WSJ reported.

And according to USA Today, there’s another reason: “economic incentives” for doctors and hospitals to use these procedures, including bonuses for labor inductions which add costs and increase the risks for C-sections (surprise!).

So there you have it: for the sake of economic incentives, convenience, and control over what day and even time of day the birth occurs, babies’ lives are being put in danger – at an additional annual cost of $3 billion to the U.S. health care system.

From birth through teenage years, our current health care system has a goal of maximizing each new little profit center we usher into their business model. Because that’s what the system is designed to do, put profits first at the expense of everything else, including the health of our babies.

What chance do YOU have against this system?

Educating yourself and your family to their business model and their seemingly endless tricks to maximize profits. Because an educated and healthy consumer is the worst enemy of our current “sick care” model that passes for health care in the US.

Wait a Minute, Isn’t This Outrageous?

The drug and medical industry’s mounting greed IS outrageous, especially when you consider in this specific instance of C-sections the National Institutes of Health (NIH) says that 33 to 75 percent of C-sections are totally unnecessary! What’s really maddening is that a study done between 2005 and 2006 showed that the cost of hospital charges for maternal and newborn care rose from $79 billion to $86 billion in just one year, with $2.5 billion of it as a result of unnecessary C-sections. In fact, delivering babies is the #1 profit center in hospitals, and rising every year.

Some points to ponder:

  • In 2008 (latest data available) facility charges billed for “mother’s pregnancy and delivery ” and “newborn infants” ($98 billion) far exceeded charges for any other hospital condition in the United States.
  • “Mother’s pregnancy and delivery” and “newborn infants” were the two most expensive conditions billed to Medicaid in 2008, involving 26 percent of hospital charges to Medicaid, or $46 billion.
  • Nineteen other countries in the world have lower C-section rates than the U.S.; 29 nations have lower maternal mortality rates; 35 have lower early neonatal mortality rates; and 33 have lower neonatal mortality rates.

How pregnant women are big bucks to the medical doctors.This last statistic is particularly concerning, because despite outspending every nation on the planet on healthcare, there are 29 or more countries ahead of the US in key childbirth related mortality rates. Simply stated, the US spends more money to have more mothers and both pre-term and full-term children die than just about 30 other nations.

But I’d venture a guess that our profit margins for corporations contributing to these staggeringly bad mortality numbers is NOT below those in the other 30 nations that are safer places to have a baby.

And if there were stockholders who held shares in something called the “public health” corporation, they would be in absolute revolt over these numbers and boards of directors of this corporation would be under pressure to resign. Wait a minute, isn’t the US Government the head of something much akin to a “public health” corporation?

So where is the outrage in the shareholders (you)?

Some Top-Selling Drugs Cause More Harm than Good

I don’t even need to say the word Vioxx to explain how some drugs do more harm than good. From anti-psychotics to pain-killers, cancer drugs and statins, many top-selling drugs are nothing more than ways to make drug companies and drug prescribers simply richer.

As an example, I’m offering this short list of drugs that, like Vioxx, have shown they can cause harm. But be aware: This is just a sampling. The list of all the drugs that belong in this category is so long it’s not possible to include them all here:

  • Avandia, the diabetes drug for which its maker, GlaxoSmithKline, has agreed to pay $250 million to settle 5,500 claims, can cause heart attacks and kill users. GSK said in January it planned to set aside $6.4 billion for costs relating to litigation on this drug. LINE BREAK Avandia was recently pulled off the market in Europe due to its health risks. A 2007 study linked it to a 43 percent increased risk of heart attack and a 64 percent higher risk of cardiovascular death than patients treated with other methods. More than 80,000 diabetics have suffered lethal heart attacks from this dangerous drug.
  • 11 cholesterol drugs, commonly known as statins, are linked with serious side effects. Statins are HMG-CoA reductase inhibitors, acting by blocking the enzyme in your liver that is responsible for making cholesterol (HMG-CoA reductase). The fact that statin drugs cause side effects is well established—there are now 900 studies proving their adverse effects, which run the gamut from muscle problems to increased cancer risk
  • The birth control pills Yaz and Yasmin were touted to be safer than any other pill on the market when they first came out. But it wasn’t long before a flurry of lawsuits began claiming that they cause numerous health problems including deep vein thrombosis (blood clots in the deep veins), strokes, heart attacks and gallbladder disease.
  • Levaquin, a powerful antibiotic, has been linked to tendon ruptures of the Achilles, shoulders, biceps, hands and thumb, and is the target of multiple lawsuits.
  • Accutane, a drug that was used to treat acne for many years, is also the center of multiple lawsuits. It was pulled off the market in 2009 after users reported side effects that included severe gastrointestinal problems including Crohn’s disease, ulcerative colitis, and inflammatory bowel disease (IBD). Elevated risk of birth defects in the children of pregnant women also were reported.

Other dangerous drugs that have either been pulled off the market or are the center of lawsuits (even as they are still sold) include the smoking cessation drug Chantix, the pain killer Darvocet, the “bone-strengthening” drug Fosamax, which is made up of bisphosphonate compounds that have been found to actually contribute to bone death, the statin drug Crestor, the serotonin re-uptake inhibitor (SSRI) drug Paxil, which has been linked to suicides and suicidal thoughts, and many, many others.

At this point I would be remiss not to mention vaccines, which can wreak havoc on your immune system.

The truth is vaccines are just another way that Big Pharma makes money by selling something that might make you sick – or sicker. Just one example is the flu vaccine: officials now know that the seasonal flu vaccine in 2008-2009 did absolutely nothing to prevent flu in children – and actually increased their risk of getting H1N1!

Yet, with the help of the rulings by the World Health Organization (WHO), the CDC, the FDA and individual states’ mandated vaccination schedules, vaccine makers have a guaranteed bank roll in the form of your children.

In stark contrast to times past when vaccines weren’t such an attractive market, they’re now such a guaranteed profit center that Wall Street investors are being told to bank, bank, bank on vaccines.

Take Control of Your Own Health

We know nearly 26 million Americans now have diabetes, and over one in four of all Americans have either diabetes or pre-diabetes. We know the cost to treat heart disease in the U.S. is expected to triple by 2030, and that high blood pressure and cholesterol are “out of control” in the U.S.

We know the U.S. is the most obese country in the world, which has contributed to skyrocketing rates of diabetes, heart disease and cancer.

We also know the U.S. spends more on health care than any other industrialized country. Yet, despite all this spending, the U.S. ranks 14th in mortality rates worldwide – meaning 13 other countries have a lower preventable death rate than the U.S. despite spending less money on health care, and two of these countries are the now nearly bankrupt nations of Greece and Ireland!

But the question is — why?

Take Back Control Of Your HealthSome analysts say this poor showing is linked to declining rates of insured persons in the U.S. Others claim the figures are just plain skewed. But I suspect the high U.S. mortality rates have more to do with our obesity rates, lifestyle patterns, and our seriously flawed health care paradigm (“sick care”) than it has to do with insurance coverage or skewed numbers.

The current US “healthcare” paradigm is the one that defines preventive care as ingesting drugs to treat symptoms, not addressing lifestyle changes that can actually create wellness.

It’s a paradigm that’s being perpetuated today, even as our federal health officials tout prevention measures.

Don’t believe me? Look at the Surgeon General’s current “preventive” health plan, Healthy People 2020. While the goals of Healthy People are stated as reduced illness, disability, and death, what the plan actually stresses are assessments, diagnostic criteria, disease monitoring, and data collection.

The plan acknowledges behavior modification with dietary and lifestyle changes are important to reaching the Healthy People goals, but aside from a few sample awareness programs, the main “preventive” strategies are screening, screening, and more screening for diseases and illnesses you already have.

A “blueprint” for reformed health care compiled by the Center for American Progress and the Institute on Medicine as a Profession also has ideas for improving health care but doesn’t mention promoting wellness. The fact is no one seems to be discussing changing the paradigm of “managing sickness” that the U.S. is currently stuck in.

No one, that is, except the U.S. military.

This article is courtesy of Natural News

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